Pure tone audiogram classification using deep learning techniques.

OBJECTIVE: Pure tone audiometry has played a critical role in audiology as the initial diagnostic tool, offering vital insights for subsequent analyses. This study aims to develop a robust deep learning framework capable of accurately classifying audiograms across various commonly encountered tasks. DESIGN, SETTING, AND PARTICIPANTS: This single-centre retrospective study was conducted in accordance with the STROBE guidelines. A total of 12 518 audiograms were collected from 6259 patients aged between 4 and 96 years, who underwent pure tone audiometry testing between February 2018 and April 2022 at Tongji Hospital, Tongji Medical College, Wuhan, China. Three experienced audiologists independently annotated the audiograms, labelling the hearing loss in degrees, types and configurations of each audiogram. MAIN OUTCOME MEASURES: A deep learning framework was developed and utilised to classify audiograms across three tasks: determining the degrees of hearing loss, identifying the types of hearing loss, and categorising the configurations of audiograms. The classification performance was evaluated using four commonly used metrics: accuracy, precision, recall and F1-score. RESULTS: The deep learning method consistently outperformed alternative methods, including K-Nearest Neighbors, ExtraTrees, Random Forest, XGBoost, LightGBM, CatBoost and FastAI Net, across all three tasks. It achieved the highest accuracy rates, ranging from 96.75% to 99.85%. Precision values fell within the range of 88.93% to 98.41%, while recall values spanned from 89.25% to 98.38%. The F1-score also exhibited strong performance, ranging from 88.99% to 98.39%. CONCLUSIONS: This study demonstrated that a deep learning approach could accurately classify audiograms into their respective categories and could contribute to assisting doctors, particularly those lacking audiology expertise or experience, in better interpreting pure tone audiograms, enhancing diagnostic accuracy in primary care settings, and reducing the misdiagnosis rate of hearing conditions. In scenarios involving large-scale audiological data, the automated classification system could be used as a research tool to efficiently provide a comprehensive overview and statistical analysis. In the era of mobile audiometry, our deep learning framework can also help patients quickly and reliably understand their self-tested audiograms, potentially encouraging timely consultations with audiologists for further evaluation and intervention.

Long-term ecological restoration increased plant diversity and soil total phosphorus content of the alpine flowing sand land in northwest Sichuan, China.

The ecological restoration techniques that combine grazing, sand barriers with willows, fertilization, artificial planting, and continuous management are increasingly adopted in the management of flowing sandy land in high-altitude and cold regions. However, few studies have focused on the long-term ecological restoration effects of such technologies. This study systematically compared the vegetation and soil characteristics under different ecological restoration durations (0 (CK), 3 (F1), 14 (F2), 26 (F3), and 46 (F4) years) in the alpine sandy land of northwest Sichuan. The results showed that, with the increase of ecological restoration durations, (1) the aboveground and underground biomass of plants, and species number significantly increased, while the shannon-wiener index, margalef index, and simpson index dramatically decreased; (2) in the early stage of ecological restoration (0-3 yr), Cyperaceae accounted for the main groups, while in the late stage of ecological restoration (14-46 yr), Leguminosae and Forb groups predominated; (3) ecological restoration durations significantly influenced the total phosphorus (TP) content at a soil depth of 0-60 cm, but soil organic carbon and C/P ratio were only significantly impacted at 40-60 cm; (4) the plant and soil characteristics of F1, F2, and F3 treatments were more similar, and CK and F4 treatments were clearly distinguished on PC1 of principal component analysis; (5) there was no significant correlation between Leguminosae groups and environmental factors. Instead, a correlation between total nitrogen (TN) and Forb groups, Gramineae groups, and Cyperaceae groups was revealed. TN was very significantly positively correlated with species diversity and TP. Long-term ecological restoration improved plants biomass, plant species diversity, functional plant groups, and increased soil TP content in the alpine sandy land of northwest Sichuan.

Clinical features and prognosis of pediatric idiopathic sudden sensorineural hearing loss: A bi-center retrospective study.

Objective: Limited research has focused on the clinical features of sudden sensorineural hearing loss (SSNHL) in pediatric patients. This study is aimed to investigate the relationship between clinical features and the baseline hearing severity and outcomes of SSNHL in the pediatric population. Method: We conducted a bi-center retrospective observational study in 145 SSNHL patients aged no more than 18 years who were recruited between November 2013 and October 2022. Data extracted from medical records, audiograms, complete blood count (CBC) and coagulation tests have been assessed for the relationship with the severity (the thresholds of the initial hearing) and outcomes (recovery rate, hearing gain and the thresholds of the final hearing). Results: A lower lymphocyte count (P = 0.004) and a higher platelet-to-lymphocyte ratio (PLR) (P = 0.041) were found in the patient group with profound initial hearing than in the less severe group. Vertigo (ß = 13.932, 95%CI: 4.082-23.782, P = 0.007) and lymphocyte count (ß = -6.686, 95%CI: -10.919 to -2.454, P = 0.003) showed significant associations with the threshold of the initial hearing. In the multivariate logistic model, the probability of recovery was higher for patients with ascending and flat audiograms compared to those with descending audiograms (ascending: OR 8.168, 95% CI 1.450-70.143, P = 0.029; flat: OR 3.966, 95% CI 1.341-12.651, P = 0.015). Patients with tinnitus had a 3.2-fold increase in the probability of recovery (OR 3.222, 95% CI 1.241-8.907, P = 0.019), while the baseline hearing threshold (OR 0.968, 95% CI 0.936-0.998, P = 0.047) and duration to the onset of therapy (OR 0.942, 95% CI 0.890-0.977, P = 0.010) were negatively associated with the odds of recovery. Conclusions: The present study showed that accompanying tinnitus, the severity of initial hearing loss, the time elapse and the audiogram configuration might be related to the prognosis of pediatric SSNHL. Meanwhile, the presence of vertigo, lower lymphocytes and higher PLR were associated with worse severity.

Rhizosphere inoculation of Nicotiana benthamiana with Trichoderma harzianum TRA1-16 in controlled environment agriculture: Effects of varying light intensities on the mutualism-parasitism interaction.

Trichoderma spp., a genus of fast-growing and highly adaptable fungi that form symbiotic relationships with plant roots, rendering them ideal for practical use in controlled environment agriculture. Herein, this paper aims to understand how the Nicotiana benthamiana with inoculation of Trichoderma harzianum strain TRA1-16 responds to light intensity variation. Pot experiments were conducted under low and high light intensities (50 and 150 µmol·m-2·s-1, respectively) and microbial treatments. Plant growth, physio-biochemical attributes, activities of antioxidant enzymes, and phytohormones regulation were investigated. The results showed that for non-inoculated plants, the reduction in light intensity inhibited plant growth, nitrogen (N) and phosphorus (P) uptake, chlorophyll a/b, and carotenoid content. Trichoderma inoculation resulted in 1.17 to 1.51 times higher concentrations of available N and P in the soil than the non-inoculated group, with higher concentrations at high light intensity. Plant height, dry weight, nutrient uptake, and antioxidant activity were significantly increased after inoculation (p<0.05). However, the growth-promoting effect was less effective under low light conditions, with lower plant height and P content in plants. We suggested that when the light was attenuated, the mutualism of the Trichoderma turned into parasitism, slowing the growth of the host plant. The application of fungal inoculation techniques for plant growth promotion required coordination with appropriate light complementation. The mechanisms of coordination and interaction were proposed to be incorporated into the biological market theory.

Changes in litter input exert divergent effects on the soil microbial community and function in stands of different densities.

Soil microbial communities influence soil biogeochemical cycling by affecting the production of extracellular enzymes and the release of carbon dioxide. Changes in litter input or stand density due to thinning can affect soil microbial communities and their function by altering soil biochemical properties. However, it is unclear how or to what extent different amounts of litter input affect soil microbial communities and their function in forest stands with different densities. Therefore, we simulated litter removal, 50 % litter reduction, normal litter input, and double litter increase under field conditions by applying different amounts of litter to soils with different stand densities in the laboratory. We then measured soil biochemical properties, microbial communities, enzyme activity, and respiration rate. Our results revealed that the responses of soil dissolved organic carbon and total nitrogen to litter input were more pronounced in the high-density forest stand with poor soil than in the low-density forest stand with nutrient-rich soil, which was mainly reflected in that the addition of litter significantly decreased the concentration of dissolved organic carbon while increasing the content of total nitrogen in the soil of the high-density forest stand. In comparison to the soil carbon component, the nitrogen component of the soil was more affected by stand density. The responses of soil fungal and bacterial communities to leaf litter treatment varied with stand density, as reflected primarily in changes in the relative abundances of Ascomycota, unclassified_K_fungi, and Proteobacteria, and changes in the relative abundances of their functional groups (ectomycorrhizal fungi, saprophytic fungi, pathogens, parasites, and bacteria involved in the nitrogen cycle). Soil fungal community responses to changes in litter input are more sensitive in the high-density forest with nutrient-poor soil than in the low-density forest stand. Furthermore, litter input inhibited the activities of soil ß-glucuronidase, N-acetyl-ß-d-glucosaminidase, and acid phosphatase more strongly in the low-density forest stand. Litter manipulation primarily affected enzymatic activity in the high-density forest stand by changing the diversity and composition of the soil fungal community. However, in the low-density forest stand, litter treatment affected soil enzyme activity, primarily through changes in soil bacterial and fungal community composition, as well as soil respiration through changes in bacterial richness (Chao 1) and community composition. We conclude that how the change in litter input impacts the soil microbial community and its function, or the magnitude of the effects, is largely dependent on soil quality. Relationships among soil variables, microbial communities, and function differ between stand densities. Our study contributes to an enhanced understanding of the impact of changes in litter input due to climate change or anthropogenic activities on soil biogeochemical cycles and can also guide rationally formulating forest management approaches to improve microbial function under climate change.

Soil and vegetation conditions changes following the different sand dune restoration measures on the Zoige Plateau.

Alpine sand dunes restoration is extremely difficult but important in the ecosystem restoration. Sand dunes are known as harsh soil and poor seed bank which freed from advantages on plants growth naturally. Effective restoration measures are required to guide the sand dune restoration. Here, indigenous grass (Elymus nutans) was sown in sand dune on the Zoige Plateau and treated with no sand barrier (CK) and environmental friendly materials including wicker sand barrier (wicker) and sandbag sand barrier (sandbag). The soil conditions were assessed by measuring the soil moisture and nutrients of the topsoil, and interspecific relationship and population niche were utilized to analyze the plant community structure variances among different restoration measures. Results showed that the soil and vegetation in the sand barriers measures were better than that in the CK. The soil moisture in the sandbag measure was 16.67% higher than that in the wicker measure. The nutrients content and microbial biomass were also the best in the sandbag measures. The ratio of strong association was the highest in the sandbag measure and the lowest in the CK, whereas the plants had the highest none association ratio in the CK. In addition, the average population niche overlap ranked by sandbag (0.39)>wicker (0.32)>CK (0.26). Thus, incorporation of sand barriers and indigenous grass seeding in alpine sand dunes could promote the sand dune restoration. And the sandbag measure showed a stronger improvement effect on the sand dune soil and vegetation conditions than the wicker measure.

[Relationships between phosphorus fractions concentrations in Pinus sylvestris var. mongolica needles and soil available phosphorus].

To make clear whether Mongolian pine (Pinus sylvestris var. mongolica) plantation is limited by soil phosphorus (P) supply in southeast Horqin sand land and to find out the best leaf indicator of soil P supply, the concentrations of total P, inorganic P and organic P in the needles of different age of P. sylvestris var. mongolica and the soil available P were analyzed. The results showed that in the study area, soil available P was rather low (0.12-0.63 mg x kg(-1)), and had significant correlations with the inorganic P (cPi) and total P (cPt) concentrations in the current-year needles of P. sylvestris var. mongolica. The significant correlation between soil available P and needle cPt derived from the significant correlation between cPi and cPt. Compared with cPt, cPi could reflect the level of soil P supply more accurately and directly.